Feds urged to compel drug company transparency

Several prominent Canadian doctors are calling on the federal government make regulation changes that would compel drug companies to reveal their payments to doctors.

In an open letter to Health Minister Jane Philpott Friday, more than a dozen physicians and health-policy leaders who form the group “Open Pharma,” write that drug companies need to be compelled to disclose how much money they pay out to doctors, hospitals and health care groups.

They say patients have a right to know of any financial ties between their physicians and the pharmaceutical industry.

“Patients should have full confidence that healthcare professionals make decisions focused on their needs without hidden conflicts of interest,” they write.

The group notes that several other countries have already “made major strides” in bringing transparency to the issue of drug company payments, and “it is long past time for Canada to follow the lead.”

Earlier this summer, several big-name drug companies began listing on their websites how much total money they pay out to doctors, hospitals and health care groups.

But many observers criticized the move as little more than a public relations gesture, saying the companies didn’t go far enough to inform Canadians about the influence they have on doctors.

For example, the companies chose to list only their overall payments to health care professionals -- not how much they paid to individual doctors.

The issue of transparency in drug company payments to doctors has been under particular scrutiny given the current opioid crisis, and the influence some companies may have had on doctors’ prescribing choices.

The Open Pharma letter writers note there is a “large body of evidence” that has found pharma company relationships and payments can also influence the positions taken by experts when devising clinical guidelines, which are used to guide doctors on which medications to use to manage certain illnesses.

Dr. Joel Lexchin, a member of Open Pharma, told CTV News earlier this year that doctors can be influenced by drug companies – consciously or not. For example, when they receive gifts or payments from drug companies, they might feel an obligation to repay the companies, including by prescribing products they might not have otherwise considered.

In their letter Friday, the Open Pharma letter writers acknowledge that pharmaceutical companies have long interacted with doctors, and that the companies have an important role to play in sponsoring important clinical research.

“Regardless, the basic principle of transparency requires that patients and the public be informed when a prescriber has taken payment directly from any party with a financial interest in one or more drugs.”

As for what needs to change, the doctors say “the machinery already exists” for the federal government to step in and compel drug companies to disclose payments.

They point to the Patent Medicine Prices Review Board (PMPRB), whose regulations, they say, could be amended to require that drug makers disclose payments to prescribers, health care institutions, societies and organizations.

They suggest that companies be compelled to release information on payments once a year, and that the PMRB then make that information public. The regulations should also be amended, they say, to set "meaningful penalties" for drug companies that refuse to comply.

Andrew MacKendrick, press secretary for Minister Philpott, told CTVNews.ca the minister has seen the Open Pharma letter and remains “open to new approaches to increase transparency for Canadians.”

He added that the letter makes specific proposals about the PMPRB and that the ministry will “look into the recommendations to better understand them.”

He added there is also room for the provinces and territories to look at what mechanisms they have at their disposal in advancing more payment transparency, and that the country’s colleges of physicians and other medical regulatory bodies also have roles to play.